Knowledge the Key to Running Private Medical Practices

Physicians are facing many fears. Prime among them is an uncertain financial future. Anesthesiologist David Norris recommends acquiring sound business skills.

This summer I took the family on a trip to Germany. My son was a little fearful of flying, particularly over the ocean. So, he and I picked up a book about planes and learned how they work. We also learned how safe it is to fly. When we approached the gates, he wasn't fearful but excited about the trip.

Much like my son, physicians are facing fears today. They are fearful of their future, especially their financial future because of so many unknowns. Fear is that unpleasant emotion caused by the belief that something is dangerous and likely to cause pain or is a threat. These threats loom all around us as rate reductions and rising costs threaten our way of life. Protocols and practice guidelines seem to dictate our actions more and more. Porter's Five Forces are working and physicians are having a difficult time adapting. There is a fear of being sidelined and substituted by other healthcare providers including physician extenders. These fears seem to be driving many to become employed or leave medicine.

Some physicians believe that in becoming employees, they will no longer worry about costs or practice revenues because that will be someone else's job; thus alleviating their fears. They seem to think that life will be better and the pressures of running their businesses will vanish. However, the pressures simply change and usually at a cost to the physician. The new individuals dealing with these pressures will not do it for free. They charge a fee that equals any excess added value and revenue physicians offer. Physicians are now beholden to someone else's motives, goals, and objectives. They have traded independence for perceived security, and clinical decision making for protocols, all because of fear.

So where does this fear originate? I believe it stems from most physicians' lack of understanding business principles. We are missing some of the skills and knowledge needed to operate a small business. It's not our fault though. Unless you took a business class or two during your undergraduate studies, it is unlikely you were ever presented this information. Our medical education, as good as it is, seems to be missing one vital key component: business education.

Here's the interesting part: Many physicians I speak with recognize they do not understand the information presented on financial reports. The information showing the financial health of their organization remains a mystery to them. Just like when they were first given a metabolic panel to interpret, they are confused. However, they were able to learn medicine and they are able to learn the discipline of business. Physicians will either improve themselves and grow or sell themselves. The latter occurs because of a lack of knowledge and understanding which leads to fear.

Fear is conquered with education. As my son learned, once you understand something, it is not as frightening. I hope that each physician will go out and pick up a book on financial reports, leadership, or operational management. They can join societies and read publications, like this excellent one, to expand their network of resources and fund of knowledge. 2014 is bright and can be prosperous, but physicians will have to work at making it so. You will have a better chance if you educate yourself and learn. There is only one of you - why not make it the best "you" possible by growing? Go conquer your fears with a little knowledge.

David J. Norris, MD, MBA, CPE is an anesthesiologist at Wichita Anesthesiology Chartered in Wichita, Kan., the owner of the Center for Professional Business Development, which aids and educates physicians and other small business owners, as well as a member of the Physicians Practice Physician Advisory Board. What is your biggest practice-related fear? Tell us at Unless you say otherwise, we'll assume that we're free to publish your comments in upcoming issues of Physicians Practice, in print and online.